The Ho Chi Minh City Social Insurance Office: What are the guidelines on declaration of increases and decreases in social insurance, health insurance, and unemployment insurance before processing claims for sickness, maternity benefits?
- The Ho Chi Minh City Social Insurance Office: What are the guidelines on declaration of increases and decreases in social insurance, health insurance, and unemployment insurance before processing claims for sickness, maternity benefits?
- What are the cases where employees enjoy the sickness benefits in Vietnam?
- What are the time limits for settlement of the sickness and maternity benefits in Vietnam?
The Ho Chi Minh City Social Insurance Office: What are the guidelines on declaration of increases and decreases in social insurance, health insurance, and unemployment insurance before processing claims for sickness, maternity benefits?
On April 10, 2024, the Ho Chi Minh City Social Insurance Office issued Official Dispatch 2100/BHXH-TST 2024 download regarding the declaration of increases and decreases in social insurance, health insurance, and unemployment insurance before processing claims for sickness, maternity benefits.
The declaration of social insurance (SI), health insurance (HI), unemployment insurance (UI) documents, and requests for processing claims for SI, sickness, and maternity benefits from employers in Ho Chi Minh City have generally been carried out in accordance with regulations. However, there are still some cases where the procedures have not been followed correctly, affecting the rights and benefits of employees.
To address this situation, according to Clause 6, Article 21 of the Law on Social Insurance 2014, which stipulates the responsibilities of employers to "provide accurate, sufficient and prompt information and documents relating to the payment of social insurance premiums and enjoyment of social insurance at the request of competent state management agencies or social insurance agencies," the Ho Chi Minh City Social Insurance Office requests employers to implement the following:
(1) Regarding the declaration of receipts and cards:
- In cases of reduced work due to sickness or maternity leave, the employer must submit a declaration of reduced work (option OF) under the main unit code and a declaration of increased work (option TM) under the code for long-term sickness (code AD). When the period of long-term sickness ends, the employer must be responsible for preparing and submitting a declaration of increased or decreased work to the social insurance agency within 30 days.
Note: The employer should use Form D02-LT to declare the reduction of sick leave (option OF) in the following cases:
+ Sick leave for more than 14 working days in a month with a diagnosed illness listed in the long-term treatment list attached to Circular 46/2016/TT-BYT.
+ Sick leave for more than 14 working days in a month for illnesses not listed in the long-term treatment list. If the sick leave is less than 14 working days in a month, the employer does not need to declare the reduction (option OF).
- In cases of maternity leave, the employer must submit a declaration of reduced work (option TS) under the main unit code. When the maternity leave period ends, the employer is responsible for submitting a declaration of increased work to the social insurance agency.
- In cases of adjusting the insurance contribution based on the resolved benefits, which affects the benefit level, the employer should submit an adjustment request according to the regulations in Section b, Point 1.1, Clause 1 of Official Dispatch 4733/BHXH-CSXH in 2019.
Download Form D02-LT here
(2) Regarding the processing of sickness and maternity benefits:
When an employee is eligible for sickness or maternity benefits, the employer should promptly prepare and submit the necessary documents to the social insurance agency to ensure the rights to medical treatment and the enjoyment of social insurance benefits.
(3) Payment of social insurance contributions:
If the employer uses the Mobile Banking application of a bank to pay social insurance contributions, they should enter and select the payment information accordingly.
If the employer uses other channels or creates payment orders, the payment order should clearly state the payment structure:
"BHXH"+"103"+"00"+Unit code+Social Insurance Agency code+insurance type code+"dong BHXH"+
When making payments through banks or treasury agencies, the employer should provide the full payment details as instructed to ensure that the contributions are correctly allocated to the designated unit.
If the employer fails to follow the correct payment structure, provide incomplete payment details, or declare changes in contributions late, resulting in additional costs for medical treatment, interest charges, or affecting the social insurance and health insurance benefits of workers, the employer will bear full responsibility.
The above is the guidance for declaring increases and decreases in social insurance contributions before processing sickness and maternity benefits, issued by the Ho Chi Minh City Social Insurance Office.
The Ho Chi Minh City Social Insurance Office: What are the guidelines on declaration of increases and decreases in social insurance, health insurance, and unemployment insurance before processing claims for sickness, maternity benefits? (Image from the Internet)
What are the cases where employees enjoy the sickness benefits in Vietnam?
Pursuant to the provisions of Clause 1, Article 3, Circular 59/2015/TT-BLDTBXH, the employees specified under Points a, b, c, d, dd, Clause 1 and Point b, Clause 2, Article 2 of Decree 115/2015/ND-CP shall enjoy the sickness benefits in the following cases:
- The employees have disease or accident which is not work accident or treatment of injury or disease recurred due to work accident, occupational disease and must take sick leave with certification from the competent medical facility as regulated by the Ministry of Health.
- The employees must take leave to take care of their sick children under 07 years of age with certification of the competent medical facility.
Female employees return to their work befire the expiration of maternity leave subject to one of the case specified above.
What are the time limits for settlement of the sickness and maternity benefits in Vietnam?
Pursuant to the provisions of Article 102 of the Law on Social Insurance 2014, regulations on settlement of the sickness and maternity benefits are as follows:
Settlement of the sickness and maternity benefits
1. Within 45 days after return to work, an employee shall submit the dossier specified in Clause 1 or 2, Article 100, or Clause 1, 2, 3 or 4, Article 101, of this Law to his/her employer.
An employee who ceases working before the time of childbirth or child adoption shall submit the dossier specified in Clause 1 or 3, Article 101 of this Law and produce his/her social insurance book to the social insurance agency.
2. Within 10 days after receiving a complete dossier from an employee, the employer shall make a dossier as specified in Article 100 or 101 of this Law and submit it to the social insurance agency.
3. Responsibilities of the social insurance agency:
a/ To settle the social insurance benefits and make payment to the employee within 10 days after receiving a complete and valid dossier from an employer;
b/ To settle the social insurance benefits and make payment to the employee within 5 working days after receiving a complete and valid dossier from an employee who ceases working before the time of childbirth or child adoption.
4. If refusing to settle the social insurance benefits, the social insurance agency shall issue a written reply clearly stating the reason.
Thus, based on the above regulations, sickness benefits will be settled within the following time limit:
- Within 45 days after return to work, an employee shall submit the dossier to his/her employer.
- Within 10 days after receiving a complete dossier from an employee, the employer shall make a dossier and submit it to the social insurance agency.
- Within 10 days after receiving a complete and valid dossier from an employer, social insurance agency must settle the social insurance benefits and make payment to the employee;
Thus, the time to settle sickness benefits for employees does not have a specific number of days, but is based on the timelines specified above.
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